精子形态与宫腔内人工授精妊娠结局的关系

目的回顾性分析宫腔内人工授精（IUI）周期中精子形态与临床妊娠率及子代安全性的关系。方法281个IUI周期按精子形态分为轻、中、重度畸形精子症和正常形态4组，统计临床妊娠率；观察IUI的子代安全性，以1，226例自然妊娠者为对照组，比较两者的多胎率、流产率、早产率、剖官产率、出生缺陷率和围生儿死亡率。结果畸形精子症组的总临床奸娠牢为9．20％，正常形态组临床妊娠率18．69％，两者差异有统计学意义（P〈O．05）；轻、中、重度畸形精子症组的临床妊娠牢分别为12．86％、7．46％、5．4％，组间差异无统计学意义（P〉O．05）；IUI组与自然妊娠组多胎率（11．11％vs．3．75％）、异位妊娠牢（13．89％vs．4．65％）、剖宫产率（76．00％vs．46．63％），均有显著差异（P〈0．05），流产率（16．67％vs．10．69％）、早产率（13．33％vs．7．03％）、出生缺陷率（3．57％vs．5．02％）和围生儿死亡率（0％vs．0．74％），差异无统计学意义（P〉0．05）。结论精子形态影响IUI的临床妊娠率；对于畸形精子症患者，IUI是一种安全的助育方法。

The relationship between sperm morphology and the outcome of intrauterine insemination

Objective： To analyze the relationship between sperm morphology and clinical pregnancy rate of intra uterine insemination （IUI） and the safety of resultant offspring. Methods： Two hundred and eighty-one IUI cycles were divided into 4 groups according to the rate of normal sperm morphology （normal： 〉14% ; mild, moderate and severe abnormal： 9-14%, 4-9% and 4%, respectively）. A total of 1,226 natural pregnancies were selected as control group. The rates of multiple births, abortion, ectopic pregnancy, premature delivery, Caesarean birth, birth defect and perinatal death were compared between groups. Results： The clinical pregnancy rate of abnormal morphology group was 9.20%, significantly lower than that of normal morphology group （18. 690/00） （P〈0.05） ; The clinical pregnancy rates of mild, mod- erate and severe abnormal groups were 12. 86%, 7. 46% and 5. 4%, respectively, with no significant difference between groups （P〉0.05）; There was a significant difference in multiple birth rate （11.11% vs. 3. 75%）, ectopic pregnancy rate （13. 89% vs. 4. 650//00） and Caesarean birth rate （76. 00% vs. 46. 63%） between IUI group and natural pregnancy group （P〈0.05）, but no significant difference was found in abortion rate （16.67% vs. 10.69%）, premature delivery （13.33% vs. 7.03%）, birth defect rate （3.57% vs. 5.02%） or perinatal death rate （0% vs. 0.74%） （P〉0.05）. Conclusions： The sperm morphology affected clinical pregnancy rate of IUI treatment, but IUI treatment for the couples with tetratozoospermia could be a safe method of assisted reproduction.